Recently, I received a question from a DailyStrength member wondering how she missed her son’s scoliosis. And while it is human nature to look back and determine where we have erred, what I’d rather do here is share a few important points about scoliosis in children, including some of the more common treatment measures this member’s son may encounter in the near future.

As most of you are aware, scoliosis is simply an abnormal curvature of the spine. Although a true cause is unknown, if I hear of a family history of scoliosis, my concern for the child will always be higher. In most situations, a child will not feel any symptoms. And keep in mind, the spine does have a natural “S” shape to it when looking at it from the side. What may be noted, however, and something I look for in my exams, is uneven shoulders or waistlines, a scapula (AKA the shoulder blade) that is more prominent (i.e. sticks out further) than the other one, and even a child leaning more to one side than the other. When the scoliosis becomes more severe, back pain may then occur and even some bulging out of the ribs (on the chest side) may be noted.

And as I’ve mentioned above, while we don’t know the true cause of scoliosis, we do know it occurs more often in females, the prognosis is more concerning when found in the younger aged children, and those with upper spine curves have a worse prognosis in comparison to those with lower spine curves. Furthermore, there is a congenital (when a newborn is born with it) form of scoliosis, and as would follow, the problems associated with it can be greater.

So during my routine physical exams, I will determine the shape, location, and direction of the curvature as well as note any leg length differences (something not to be overlooked). If a concern for scoliosis exists, I will then obtain x-rays (“scoliosis films”). The scoliosis films will determine the angle of the curve and if the spinal curvature is significant enough, a referral to a pediatric orthopedist is in order.

Now mild curves do not require any treatment although routine follow up is needed to ensure the curve is not worsening (typically every 4-6 months). And if treatment is deemed necessary, there typically are two ways to approach the problem based on how significant the curve is–either braces or surgery. The braces prevent any worsening of the curvature, but will not reverse the curve. And surgery is typically reserved for significant curves where the bones of the back (vertebrae) in the area of the curve are fused together.

Just another reminder of how important routine annual physical exams are for your children.

Dr. Jeremy